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HomeMy WebLinkAbout20196-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. IIPDATED CERTIFICATE OF OCCOPANCY No Z-22914 Date MARCH 23, 1994 THIS CERTIFIES that the building NEW DWELLING Location of Property 8980 NASSAII POZNT ROAD COTCHOGUS, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 118 Block 6 Lot 3.3 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AIIGIIBT 8, 1991 pursuant to which Building Permit No. 20196-Z dated OCTOBER 9, 1991 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued ie ONE FAMILY DWELLING WITH ATTACHED PORCH AS APPLIED FOR * The certificate is issued to HARRY & JANET HOHN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-30-88 - JDLY 6, 1993 UNDERWRITERS CERTIFICATE NO. N-247669 - AUGIIST 21, 1992 PLUMBERS CERTIFICATION DATED DEC. 1, 1992 - EDWARD F. SCHILLER *NOTE: THIS IIPDATES CO Z-22456 DATED JULY 15, 1993 O2~ ? _ ui ding In p~tor Rev. 1/81 >ro16M NO TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N 2 01 9 6 Z Date .....1 19.9..1. Permission is hereby granted to: ...Y.:..~ ................I.Y..~!~!:!.............. ......X40...~::......l~.le ~.~..n~.:. y.:......t a a..a.~.......... to ~ c4~~.... 11 at premises located of ...~.~i N 7 County Tox Map No. 1000 Sectio////n ~~~~.......~,1..~......... ©Biock .......~.~a...p.. Lot No....~.: 1 pursuant to application doted ...k.W..~.......q 19..t..~.., and approved by the Building Inspector. I Fee s... 9°..:.' Building Inspector Rev. 6/30/80 " Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of .property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 19, lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. ` 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing'! land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ,,,,March 23: 1994 New Construction........... Old Or Pre-existing Building Location of Property..... 8980 NASSAU POINT ROAD CUTCHOGUE: NEW•YORK House No. Street Hamlet Onwer or Owners of Property ......,HARRY & JANET HOHN . County Tax Map No 1000, Section......~~s.....Block....6...........Lot...3"~ Subdivision ....................................Filed Map............Lot...................... 20196-Z 10/9/9] HARRY & JANET HOHN Permit No ................Date Of Permit................Applicant............................. Health Dept. Approval.., 91. SO-88 ,,,,,Underwriters Approval „ N.247669 . Planning Board Approval Request for: Temporary Certificate........... Final Certicate „ JJ~p{~T$p,CO Fee Submitted: 50:00... „~SJ'~-~-A~.t.cL CU ] }Y _ PLI NT R ~ FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ha11 Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22456 Date JULY 15, 1993 THIS CERTIFIES that the building NEW DWELLING Location of Property 8980 NASSAU POINT ROAD CUTCHOGUE N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 118 Block 6 Lot 3.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 8, 1991 pursuant to which Building Permit No. 20196-Z dated OCTOBER 9, 1991 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ATTACHED PORCH AS APPLIED FOR The certificate is issued to HARRY & JANET HOHN (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 91-SO-88 - JULY 6, 1993 UNDERWRITERS CERTIFICATE NO. N-247669 - AUGUST 21, 1992 PLUMBERS CERTIFICATION DATED DEC. 1, 1992 - EDWARD F. SCHILLER __\L~ ilding Inspector Rev. 1/81 Form No. 6 ~ ~ ~1 ~~~1,~ -ra r ~ TOWN OF SOUTHOLD ~ , t r ~ ~ . ; . ~ BUILDING DEPARTMENT TOWN HALL ~~,i, ~ ~ f~? ~ 765-1802 t. . " APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 19 lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. e 6. Submit Planning Board Approval of completed site plan requirements. B, For existing buildings (prior to April 9, 1957) uon-conforming uses, or buildings and !'pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residen/tial $15.00,QQC..ommercial $15.00 Date (.2,... ?,.2.:.. J.~ . New Construction.. ~jCj.. OldO~r/ Pre-existing Building. Location of Property..Q?.~~...!V~:SSAU, PD/Nr„l<~.~,,,,,,,,,, ~tJTC~/O ~.CJ~ House No. ` /S,gtreet Hamlet Onwer or Owners of Property.. l~A~~,1pp...~ ...Y.: f~E~.... y!:/ County Tax Map No 1000, Section...! a.......Block....~ 6.........Lot... 3:.I Subdivision ....................................Filed Map............Lot...................... Permit No.~~~.[ .,Date Of Permit..~~.I.././ 1~.....Applicant Health Dept. Approval ..........Underwriters Approval......................... Planning Board Approval Request for: Temporary°°°°Certificate........... Final Certicate..../...... V f Fee Submitted: $.~,7,`, C"; ~o as ysb ~v f f l / 3 U ~ D 7r,,S4 f APPLICANT ..SOGJ7~ O.4, ~ /V ~ y. INSPECTORS _ _ Victor Lessard ~`y^~,}FFO(~ Principal Building Inspector p~~ V.,,;: °di~, Curtis Horton s~~~ SCOTT L. HARRIS, Supervisor Senior Building Inspector 4k""~!° : L Thomas Fisher F'' l` _ ~ Southold Town Hall ' ^r 'v P.O. Box 1179, 53095 Main Road Building Inspector ~ 4 r Gary Fish " • ~pl.T,' Southold, New York 11971 Building Inspector 1 ~ ~'r Fax (516) 765-1823 Vincent R. Wieczorek -~-~~"r Telephone (516) 765-1800 Ordinance Inspector Robert Fisher Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR Telephone (516) 765-1802 TOWN OF SOUTHOLD NOVEMBER 27, 1992 ' JANET S HARRY HORN 200 EAST 66th STREET NEW YORK, NY 10021 RE: PREMISES @ 8980 NASSAU PT RD, CUTCHOGHE, NY To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: %%x An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. » The check is not on file.)$25.00 %X% No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20196-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ~~~FQ(~-`, TEL. 765-1802 o~o,,~. TO~Y'N OF SOtiTTII~d.PJ .f _ OFFICE OF BUILDIi~iG INSPECTOR u°, E `_3~,~; P.O. BOX 1179 'e' TO~VNHALL %Ol ~,~p~' SOUTHULD, N.Y. 11971 C E R T I F I C A T I O N Date ~ ~2~ Building Permit No. ®V ~ f ~ Z Owner Q`. (p ease print) Plumber ~OGf/19~2/7 ~ J CFft'GC (please print) I certify that the solder used in the water supply sysbem contains ,less than 2/10 of to lead. (plumber's signature) Sworn to before c this otary Public Notary Public, County- JOYCE M. WII.KINS dotery PubNo, state of New York Na 4862246, Suffolk Courr~~~~yy Term E~q+iresJuee 12, tS.~s THE NEW YORK BOARD OF FIRE UNDERWRITERS PACF; ~ ~eaa~s BUREAU OF ELECTRICITY 65 JOHN STREET, NEW YQRK, NEW YORK 70038 Date AUGUa2' 21,J.192 Application No. on file %'761yD92192 N 247fi•T2 THIS CERTIFIES THAT only the electrical equipment as deacrihed below and introduced 6y the applicant Homed on the shove application numher in the premises of t BARRY HUHN, NASGAU PU7:MT RUAD, PU.g35G-DU, CUTCHt'1GUEr N.Y, in thefoBowinq location: ©Basemen[ ? Ixt F'I. ? 2nd FJ. UUT A.IiGUyt' 17 Sertion Block Lot was examined on n. r 1 !J 9 ~ and found to be in conrplianrc with the requiremenLC of this Board. FI%7URE ECEPTAClES SWITCHES FIXTURES RANGES COOKING DECK$ OVENS DISH WASHERS EXHAUST FANS OUTLETS INCANDESCENT FLVORESCENi OTHER PMi K W. AMT. K W. PMi K.W PMi K.W AMT H P I i DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CIOCK$ SELL UNIT HEATERS MULTI-OUTLET DIMMERS PMT. K W. OIL H P. GA$ H. P AMT NO. A W G. AMT. AMP. AMT. AMPS TRANS. AMT. H. P SYSTEMS NO.OF FEET nMT. wATTE SERVICE DISCONNECT METER S E R V I C E AMi AMP 1YPE EQUIP. ~ % I .a 3W 3 A' lW 3A' 4W NO. OF CC, COND A. W G. NO. Of H4lEG A W G. PER % Gf CC. COND OF HbIEG NO Of NEUtRAlS OF HEVTR~AI i 2t~9 ra ~ a ~ 4f0 ~ r~ OTHER APPARATUS: JUDY PUMT:LP,O LCC,~23Q0_E L~C?~~~G!i! " PAT BANE MAT'1'LT[7CK, NY, 11+152 GlNERAE MANAGlR 11 lc This certificate must not be altered in any manner; return to the office of the Board if Incorrect. Inspectors ma~be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CER IFICATE MUST NOT BE ALTERED IN ANY MANNER. aoi9~~ g THE NEW YORK BOARD OF FIRE UNDERWRITERS PAr,E f 1001.331 BUREAU OF ELECTRICITY 83 JOHN 5TREET, NEW YORK, NEW YORK 10038 Date A.NGNfiT 27 rP.992 Application No. un file 77679792J92 N 71376~!~ THIS CERTIFIES THAT only the electrical equipment as described below and introduced 6y the applicant named on the above application number in the premises of HARt2Y ifQl{tl, 89$0 S1AS~iAU Pg1:PET ROAD, 4UTC,4IOCrUF, N.Y. ~ in the following location> ®Basement ® /at Fl. ©2nd F'l. GAR/ONR Sertinn Block Lot uws exarnined mL AUGU9T 1. f r 1992 and fowrd to be in compliance with the reyuirentenLS q(thia Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS ECEPTACLES SWITCHES CUTLETS INCANDESCENT FNORESCENT OTHER M1i K.W. AMT. K.W AMi K.W AMi K.W AMT. N.P. 122 R 8:9 7.17 5 1. 5.8 1 L 2 6 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAI REC'PT TIME CLOCKS gEll UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K. W. OIL H P GAS H. P AMT. NO. A. W. G. AMT. AMP AMi AMPS TRANS. AMT. H. P SYSTEMS PMi WATTS NO.OF FEET 2 P 7. 20 1 ifl SERVICE DISCONNECT NO.OF S E R V 1 C E 99 AMT. AMP. TYPE METER ~ TW ~ ~ AW 3 %JW 3 %4W NO OF CC. COND A. W. G. NO OF HbLEG A W. r' NO Of NEUTRALS A. W. G. S EQUIP. PER % OF CC. COND OF HI-LEG OF NEUTRAL X 1 200 CD 9. $ 1 +310 1 10 OTHER APPARATUS: 7.0K6J GENECtATON-9. JACCUZZT-1 HOfO[2St3-F N. P,,3-3 H.P, PANELBtSAItDBr1_g CIR. 100,1.-ta C'I:It. 9,00 G.F,C.Ir-10 St{OKE l1kTGCTORx-~ JODY PUMIGL© LTC.#2300-E G/~~~ ' PAT LANE NA1'1'f.TUCKr fl~r 1195?. GENERAL MANAGER 11 Per This certificate must not 6e altered in any manner; return to the office of the BDOrd if incorrect. Inspectors may be identified by their creden}ials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. c'lEL~~-UC;'_U;J ~~U6:E I COCiMENT° °Tr: -n 1 . r a O _ H FOUIJDATION (1st) ~ tf' FOUNDATIOIJ (2nd) - - m 2 . 3 a.o s ~ , z 0 op P.OUGH FRAME & ,1 ~ ~0 d •PLUMBINC ti 3. y ~ m IIJSULATION PER N. Y. m H ~ STATE ENERGY ' CODE I L ~ x it "3 FI;JAL I o ~ , ADDTTIOhJAL COMhfE1JTS: x ' , ,2 '^-,e- C,o. x • ' W ' H H O ~O 2 ~ m -0 • A ~ r ~ • - Z QA 'Q : t m • ~ - H e ® 1 , Ntw York State Department of Environmental Conservation , Building 40-SUNY, Stony Brook, New York 11790-2356 ` 0516) 751- 1389 ; Thomas C. Jorling Commissioner July 23, 1991 Harry G. and Janet Hohn 200 East 66th St. New York, N.Y. 10021 i MODIFIED PERMIT 51-4738-00203/00001-0 Dear Mr. & Mrs. Hohn: In conformance with the requirements of the State Uniform Procedures Act CArticle 70,ECL) and its implementing regulations (6NYCRR, ?art 621) we are enclosing your permiC. Please read all conditions carefully. Zf you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted aC the project site and protected >:rom the weather. Very truly yours, S3 ~ t i Robert N. Thurber Sr. Environmental Analyst RNT/rw enclosure Y ' ~ ~ ~ • h5-211b (1UI')fq-i5C NI Nt..~RK SIA l1 Ut I'ARTh11 NI OI kNVIRONAAI NIAI (ON511. IIUN • DFC I'lRMlf Nl1MekR IffLCilvl DATE 1-4738-00203/00001-0 July 23, 1991 ' - - - - kACIIITYII'ItOGRAMNIIMIIIR(s} PERMIT I%I'I linll(IN UAII Under the Envinxunenral Conservation Law (EC1) June 30, 1996 Revised Special Conditions on Page 3of4 /YPF OF PERMh (Che11c--klI All Apphcnhle eoxesl I ' ?New _~.lltenew,ll _ C~ModJ,~elion ?I'enuatoConslmcl ?I'arnullu(JP~reU• i I1 Proltelction ofllWa er ~ SPDES 17' Titles 7, & ~ Hazardous Waste ~Management3l Article' 15, Title 15: Article 19: Article 34: L__J Water Supply ' ' L-1 Air Pollution Control ~ Coastal Erosion Management Arlicle, l5, Title 15: ~ ~ Article 23, Title 27: Article 36: I~-J Water Transport Mined Land Reclamation l -J Floodplain Management Longelsland IWellsS• ~ Frelshwater Wetlands' C~ 6NYCRR1380: Rad a9ion Control Article 15, Title 27: R Arlicle 25: r~ Other: _ a Wild, Scenic and Recreational ~ Tidal Wetlands ~_J Rivers ~ Article 27, Title 7; 6NYCRR 360: 6NYCRR 608: Solid Waste Management ' Water,0uality Certifiration I'f Rhtl r ISSIIFD~TO ~ Tf I f 1'I IONI NUMIit R Harry G. and Janet Hohn ~ k } _ nUDR15501 PkRMITIkF ~ • 200 EasC 66th St., New Yorlc, N.Y. 10021 CONTACT I'F RSON FOR I'I IfMITTkD WORK THkPIIONk N(IM(trR John J. Raynor, P. 0. Box 720, Wafer Mill, N.Y. 1!976 k I NAME nNU nDURk 55 OI I'IiOIECTIknC.ll ITY LOCASION OF PRO}r CTiI ACII IiY ^T-_ W/0 Nassau Point Rd., s/o Aborrr I.ane,Nassau Point, Cutc}TOgue COUNTY ~ TOW W(~I)(')6'1i>SAV(Il WATT RCOURSkIWkTIANU NO NYTM COORDINniES Suffolk Southold Great Peconic Bay _ _E_____ _ Na.__ . DESCRIPTION OF AIn HORIZFp ACT NIrY ' Subdivide a 7.37 acre parcel into 3 residential loCS, each to be in excess of one acre. A11 work shall be in accordance wiCh the 'at Cached NYSDEC approved plan -i ~ ~ ey acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (See Reverse Side) and any Special Conditions included as part of ttris permit. 2~n;al---- - _ - I'IHMII ADMIN IIIRATUl1 i nUUltl SS nOgion 7 • Cl!•:.i• l"`1 EI David Ueltidder 8lfony lSroaLq N. Y. AY790•A395 AuTnoRlzluslcNnluRf /,r~~~~ ~/n ) nnn7/'23/91 1'.Igc I uL _4_.._ f 4,.~ h GENERAL CONDITIONS j Inspections ' 1. The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). A ropy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. Permit Changes and Renewals 2. The Department reserves the right to modify, suspend or revoke this permit when: a) the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations is found; b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new material information is discovered; or d) environmental conditions, relevant technology, or applicable law or regulation have materially changed since the permit was issued. 3. The permittee must submit a separate written application to the Department for renewal, modifica- tion or transfer of this permit. Such application must include any forms, fees or supplemental infor- mation the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. 4. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. 5. Unless expressly provided for'by the Department, issuance of this permit does not rnodlfy, supersede or rescind any order or determination previously issued by the Department or any of the terms, con- ditions or requirements contained in such order or determination. Other Logal Obligations of Permittee . 6. 7hd permittee has accepted expressly, by the execution of the application, the full legal responsibili- ty for ail damages, direct or indirect, of whatever nature and by whomever suffered, arising out of the project described in this permit and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from this project. 7. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impair- ment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights- of•way that may be required for this project. Page 2 of W . pis-t(14a nqr+ul- tso ~ ADDITIONAL GENEIiAt CONDITIONS FOR ARTIC LLS 15 jTillc 51, !S, 25, 3J, 36 and 6 NVCRR Part 60A ( ) 9 Tha[ if future operations by the State or New York regwre an al- other envuonmenWlly deleterious materials assouated with [he terauon m the position of the structure or work herein authorized, nr protect if, in the opinion of the Department tit t nvuonnuenal Conservation iJ Any material dredged m the prosecuhon of the work herein permdted rt shall cause unreasonable obstruction to the trey n,ivniuuon or +aid shall be mmnved evenly, wnhout leaving large refuse piles, edges across wafers ur flood Ilows or endanger the health, sa«•ty or welfare tit the bed of a waterway or ilnodplam or deep hales that may have a the people of the Stal0. or cause lou or destine Uon of the nahual tendrncy to cause damaf;e to navigable channels or to the banks of resources of [he Stale, the owner may be ordered by the Uepartment to a waterway. remove or alter the structural work, obstruttwns, or hazards caused 1d There shall be no unreasonable interference wish navigation by the work thereby wnhout expense to the State, and if, upon the expuaaon or herein authorized. revocation of this pernut, the structure, ell. excavation, or other 15 If upon the expiration or revocation or Ilia permit, the protect hereby modification of the watercourse hereby authorized shall no[ be coin- authorized has not been completed. the applicant shall, without expense pleted, the owners, shall, without expense to the State, and to such to the State, and to such extent and in such time and manner as the extent and in such time and manner as the Department of Ernuonmenial Department of Environmental Conservation may require, remove ail or Conservation may regwre, remove albor any portion or the uncompleted any portion of the uncompleted structure or fill and restore the site structure or fill and restore to its former condition the navigable to its rormer condition No claim shalt be made against the State of and flood capacity of the watercourse. No claim shall be made against New York on account of any such removal or alteration the State of New York on account of any such removal or alteration 16 If granted under Aructe 36, this permit does not vgmfy in any wav 10 That the State of New York shall in no case be liable for anv damage that the project will be free from flooding. or mlurv to the structure or work herein authorised which may be caused 17 If granted under 6 NYCRR Part 60A, the NYS Department of Environ- bV or result from future operations undertaken bV the State roc the mental Conservation hereby certifies that the subject projectwiq not conservation or Improvement of navigation, or for other purposes, and ~ contravene effluent limitations or other hmnations or standards under no claim or right to compensation shall accrue from any such damage. 5ectrons 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 11 . Granting of this permit does not relieve the applicant of the re>ponso- (PL 95-217) provided that all of the conditions fisted herein are met bility of obtaining any other permission. consent or approval from to All actrvrties authorized by this permit must be m stmt conformance the U 5 Army Corps of Engineers, U.S Coast Guard, New York State with the approved plans submitted by the applicant or his agent as part Office of General Services or local government which maY be regwred. of the permit application. 12. All necessary precautions shall be taken to prelude contammauon of dny wetland or waterway by suspended solids, sediments, "fuels, Such approved plans were prepared by solvents, lubricants, epoxy coatings, paints, concrete, leachate or any _ on MDDIPISD SPECIAL CONDITIONS I. Development of a single family dwelling on Lot no. 1, landward (northeast) of the "Building Setback Line", toill not require a permit pursuant to 6NYCRR Part 661, provided that there is no grading, clearing, discharge of sediment, or other alteration to areas below the ,existing ten foot contour. 2. On Lot No. 1, the strip of land ten feet in width lying landward of the area of steeper slope (designated on the map accompanying this permit by a shaded of hatched area noted as "Area of 30~ Slopes") shall be kept in low maintenance plantings ar natural vegetation and shall not be mown or cut to a height less than eighteen inches (18") in order~to minimize the incidental movement of sediment and nutrients toward the bay. Vegetation may consist of indigenous plants or nursery stock, at the owner's option, but shall be planted in such a manner as to form a dense ground cover to a height of at least eighteen inches. 3. Any expansion of the existing one and one-half story house on Lot No. 2, and any regulated activity to be conducted within Che tidal 'wetlands and adjacent area on Lot No. 2, shall be subject.to NYSDEC review and permit requirements. 4. The permittee is advised of the presence of a nesting colony of Least Terns, a New 7ork State endangered species, immediately west of the pond on Lot No. 2. To avoid disturbing the Least Terns, there shall be no construction or other activity within 150 feet of any active nest between the dates of April 15th and August 31st. Supplementary Special Conditions CA) thruCJ) attached. DEC PERMIT NUMBER 1-4738-00203/00001-0 PROGRAMiFACILITY NUMBER' Page -,3__ of ._1ti_ ®~,~~Uf~OC,y~Pr TRUSTEES G~ John M. Bredemeyer, III, President ® ~ < SUPERVISOR Henty P. Smith, Vice President W SCOTT L. HARRIS Albert J. Ktvpski, Jr. Sohn L. Bednoski, Jx. Town Hall John B. Tuthill 1a 53095 Main Road P.O. Box 1179 Telephone (516) 765-1892 BOARD OF TOWN TRUSTEES Southold, New York 11971 Fax (S 16) 765-1823 TOWN OF SOUTHOLD r. September 3, 1991 Samuels & Steelman , 25235 Main Road Cutchogue, NY 11935 RE: Harry G. & Janet Hohn SCTM #1000-118-6-1 & 1.3~ Dear Mr. Samuels: The Board of Trustees reviewed the application submitted for the above referenced property. After an on site inspection, this project was determined not to be in the Trustees jurisdiction. All other approvals that may be applicable should be secured prior to the commencement of the project. Very truly yours, John M. Bredemeyer, III'" President, Board of Trustees JMB:jt cc: Building Dept. ~ o~~$~FFO(~co o~ Gy< PLANNING BOARD MEMBERS ti = SCOTT L. HARRIS Bennett Orlowski, Jr., Chairman WOy • Supervisor George Ritchie Latham, Jr. ~o~ ~~O Richard G. Ward Town Hall, 53095 Main Road Mark S. Mcponald P.O, Box 1179 Kenneth L. Edwards pLANNING BOARD OFFICE Southold, New York 11971 Telephone (516) 765-193$ TOWN OF SOUTHOLD Fax (SIB) 765-1823 October 1, 1991 John M Wagner Esseks, Hefter & Angel 108 East Main Street P.O. Box 279 Riverhead, New York 11901 RE: Minor Subdivision of Harry & Janet Hohn Nassau Point Road, Cutchogue SCTM#1000-11$-6-1,3.1 Dear Mr. Wagner: The following resolution was adopted by the Southold Town Planning Board at a meeting held on Monday, September 30, 1991. WHEREAS, Eda L. McKnight Kolbe is the owner of the property known and designated as SCTM#1000-118-6-1 and 3.1, located at Nassau Point Road and Aborn Lane in Cutchogue; and WHEREAS, this minor subdivision, to be known as Minor Subdivision for Harry G. and Janet Hohn, is for 3 lots on 7.368 acres; and WHEREAS, the Southold Town Planning Board, pursuant to the State Environmental Quality Review Act, (Article 81, Part 617, declared itself Lead Agency and issued a Negative Declaration on March 11, 1991; and WHEREAS, a final public hearing was closed on said subdivision application at the Town Hall, Southold, New York on September 9, 1991; and WHEREAS, all the requirements of the Subdivision Regulations of the Town of Southold have been met; and Page 2 Harry & Janet Hohn be it therefore, RESOLVED, that the Southold Town Planning Board approve and authorize the Chairman to endorse the final survey dated September 16, 1991. It was noted for the record that the Planning Board's approval did not refer to any land outside the boundaries of the subject parcel. Enclosed please find a copy of the map which was endorsed by the Chairman. The mylar maps, which were also endorsed by the Chairman, must be picked up at this office and filed in the office of the County Clerk. Any plat not so filed or recorded within sixty (60) days of the date of final approval, shall become null and void. ~i Please contact this office if you have any further questions. Very truly yours, Bennett Orlowski, Jr. / ~ 'Y'' S Chairman Encl. cc: Victor Lessard, Principal Building Inspector Robert Scott, Assessors Office • ~A ~ ~ o c = ~ o c~ ~ ~ O ciiC~-aa~ CCS R3, , ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Q ~ cv > a~ (A ~ LLl cn ~ ~ O- O_ ~ ~ C ~ ~o~C.L~O a Q _ cs~ ~ «S O~~ ~ ~ ® a~ ~ U- O a ~ ~ O O ~ ~ ~ ~ ~ ca -Fr ~ ~ N CI) ~ O C cn O O ® z U~u~i-'~~ ® O p c~ 0 o a... LL1 x ~ C ~ -C ~ ~ to p t~ ~ ~ ~ 0 "J ~O-+ ~ C ~ C~ ui U O C ~ ~ i U , O C O~ O n C ~ C cn ~ L U c~ Cd ~ ~ ~ C E ~ ~ ~ O a.. y_ ~ ~ ~ O ~ ~ ,._s1: , S ® ~ ~ ~ ~ ~,n. ~ Q ~ ~ ~ Q to Z ~ ~ ` ` E," csS ~ ~ a ~ , ;tl -t <:.,; m a<z-<ea~;. rs . „`th '91 13:53 FRAM NEIJ YORK LIFE PAGE•003 ,v New York State Department of Environmental ConserVat(on Building qC~-SUNY, Steny Brook, New YoNt 17790-2356 i I; (516) 751-•1389 D~ AUG - 81991 1'homa: a JorHn~ Commisaioner `.~a ~_n~z. _s . , a 7f7t5/ti f)r ~C'~lJ'PpiCJtafY Suly 23, 1991 Harry G. and JBneC Hohn 200 East 66th Sk. ~IeW York, N.Y. 14021 • ` gE; MDD7FIBD PBB!!~~ ~1-473$-00203J00001^0 Dear Mr. & Mrs. Hohn: Zn conformance with the requirements o£ the State Uaifozm pracedurea Act (Article 70,ECL) and its implementing regulations (6N'ICR12, Part 621) ' we a;e enclosing your permit. Please read all conditions carefully. If you are uztable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very Cruly yours, Kobert N. Thurber Sr. Environmental Analyst RNT/rw " enclosuze 9 '91 13:6 FROM NEW YORK LIFE PRGE.0D7 9$•10fi (10/K71•.15a NI W Yt7KK SrATl DEPARTMENT Or fNVIRONME NTAL CONSERVATION DCC rRRMIT, NUMpIH Ilill'IIVI OAII 1-473b-00203/00001-0 July 23, 1991 FACItITY1pROCRAM NUMRI KIJ PERMIT I%I'IKAIIUN Unll , I under the Environmental conservation Law (sell Sune 30, 144b Revised tipeaitFl Ca7rditione oa Yage 30€4 7YIt'1-Itli PI PMI I ICh,rck All AppticPbi~ 9o,e,1~1 - tF^^--I1 _ 1 y Ntw f~Renew,l l.aAtptli(iWNpn IJ Pe+mq <o Con,Wft ?Ppm,H In OIR'fnin I` a Article 75, Title 5: Article 17, Titles 7. 8: ~ Article 27, Title 8; bNYCRR 373: Protection cf Water ~__J SPDf5 Hazardous Waste Management ArtlDle 75, Title 15: Article 19; t Article 34: l~f Water Supply ~ Air pollution Control ~ Coastal brasion Management Article 75, ?ills 15: Article Z3, Tltie 27: Article 36: Water Transport ~ Mined sand Reclamation I~ Floodplain Management ~~I Article 15, 71tte 75: ArtlCl¢ Z4: Articles 7, 3. 17, 19, 27, 37: i ~ t Lonp island Wells ~ Freslnvater Wetlands ~ 6NYCRR 380: Radiation Contro! Article 7S, Title 27; Article 25: r•---~-, Wild, Scenic and R¢creational ~ Tidal Wetlands I J Other: tiivera Article 27, Titl¢ 7; 6NYCRR 3&01 l~ 6NYCRR 508: ~ Solid Waste Management Water Quality Certification PERMIT 155UED TO ~ If IIVIft7N1 NvM01R Harry G. and Janek Holm ~ I ApDRESS OE' PFRMn7kE ~ Z00 East .66th St., New York, N.Y. 50021 ' CONTACT Pf RSON ,pN PERMITTED WORK 1111 IV 1UN1 NUMGI H_-_ Sohn J. Raynor, P, 0. Box 720, Water Mill, N.Y. 11476 1 ) NAMi ANO ADURl55 VI I'RQIkCUEA(;0.1TY ~ ~ 40CATIUN OT PRO1F[TIMCII,ITY W/0 Nassau Point Rd., a/o Aborn bane,Naaeau Point, Cutchogu® COt)NTY 7pWNi(X~C7GY.~tFt1 WATERCDURSE(WETIAND NQ, NY1M ('OgH171NAilY Suffvltc Southold Great Peconic Bay 1 N~ Dr scRlpnoN o1 Au+rlnR,zr n AcnvtT Y 5ufadividp a 7.37 acre parcel into 3 residential lots, each to be in excess of one acre. All work shall he in accordance with the attached NYSAEC approved plan. By acceptance of this permit, the permittee sprees that the permit is contingent upon strict Compli&RCe w{th the ECI, alt appliaabla reflulatfans, the Qeneraf Conditions spec(fied (See Reverse Side) and any Special Conditions ]nclodrtid as part of this permit. PERMIT A h11N1$TRATOR Pr•'s~a~ary :t:2:.>,: David DeRidder ADDRESS Rrglsw i.eEr~^,.. 40 2:x AUTNORIytU 51(lNAIIJRI /~~jJ ~ j rlrcoaY fiE'OOlil N•Y, ii90~.23114 7/Z3/91 Pogo t of _4 , h. ar.u~i $UPF` ,MENTARY SpECIAJ,_CC)NDITI(1NS~ The following conditions apply to all permits: ' A. It any of the permit conditions are unolaar,the permittee shall con- tact the Division of Regulatory AEfaire at khe address and telephone noted below. B. A copy of this permit with supplementary conditions and approved glans shall be available at the project sits whenever authorized work is in progress. C. The permit sign enclosed with the permit or a copy of letter of approval shal"1 be protected £rom the weather and posted in a con- spicuous location at the work site until completion a£ authorized work. D. At least 49 hours prior to commencement of the project, the permittee shall complete and return the top portion of the enclosed receipt form certifying that he fa fully aware of and understands all provisions and conditions of this permit, Within one week of completion of the permitted work, the bottem portion of that Form shall also be com- pleted 'and returned. E. For projects involving activities to ba accomplished ovmr a period o! more than one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior td the Commencement of resumption of work each year. F. If graject design modifications take place after Permit issuance, the permittee shall submit the appropriate plan changes.for approval by the Regional hermit Administrator prior to undertaking any such modi- fications. The permittee is advised that substantial modification may require submission of a new application fox permit. G. All necessary precautions shall be taken to preclude Contamination of any wetlands or waterway by suspended solids, sediment, fuels solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials aspooiated with the project wank. x. Any failure to comply precisely with ail of the terms and conditions of this permit, unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. I. The permittee is advised to obt~rin any permits or approvals that may be required from the U.S. Department o! Army Corps of Engineers, NY District. 26 Federal Plaza, New York, NX 10278, (Attention: Regulatory Functions Branch), prier to commencement pf work authorized herein. J.. The granting. of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or •other.,necsssary approval from the bivision of Land Utilization, Office gE'General 8esvicea, 2'ower Building, Empire State Plaza, Albany, NY 12242, which may be required for any encroachment upon State-owned lands underwater. Regional Permit Administrator NYS Dept. of Environmental Conservation Bldg, 40, SUNY-zoom 219. Stony brook, NX 11790-235$ -y (516) 75I-790D DEC ~ ' LI / 3 O U ~~Ia ~ ~1 - a - '91 13:53 FR~r NEW YORK LIFE PAUE.004 L-.=Nr=_ URar~..~ lllAfotliFitttbn LJ PCrmil le Canya. t_1VVrm~r to Uprra~~~ I Article i5, Title 5; Article 17" Titles 7, 8: ~ Article 27, Title 9; 6NYCRR 373: Protection of Water ~ SPD~S Hazardous Waste Management Anlcle 15, Title t5: Aricle tq; Article 34: L_,.._..J Wdt9r $uppiy ~ Air Pnl(uticn Contrcl ~ Coostal Erosion Management (~`~1 Article 15. Title t5: ~ Article 23, Title 27: Article 36: (I_~_~J Water Ttansporl Minpd Land Reclamation ~ Floodpfaln Manapement ~ L_J I.onipt isl ndTlWegsS• ~ Freshwater Wetlands ~ 6NYCRRt380; RadaUvn CoM~•ol Article 15, Titlo 27 ~ ~ Article 25: ~ Wild, Scenic end Recreational ~ Tidal Wetlands Qther: Rivers Article 27, Title 7; 6NYCflR 360: t__1 ' ~ 6NYCRR 608:L Solid Waste Management Water Quality Cercification PCRMIT ISSUED TO Harry G, and Jan.eC Hohn rnrrNCrrr N11MIUN ADDRESS ISI PERMIT ItF. ~ ~ 200 East'6bth SC. T'• , New York, N.Y. 3002( CONTACT PERSON EON PkNMITTtD WORK Sahn J. Rayngt'. P. 0. Bax 720, Water Mi21, N,Y, t 1476 )IIIrNI>w NtrMrua NAME AND ADORE SS UE 1•HOI7 Crlf ACIL1TY I I _ LOCATION or PkO(F.CTrEACfLRY _ W/0 Nassau Point Rd „ slo Aborn Aane,Nasaau Point, Cutchogue COUNTY fOwN/<A1}F'~l~r~ WATFkCOVRSEhYETCANO NO NYIM I'OONUINAiE\ Suffolk Sgtlthold Great Peconic Bay E a[SCRIPTION OF AUTHONI7.ED ACTIVITY N4 , Subdivide a 7.37 acre percel into 3 residemtilEi lots, each to be in excess of one acre. All work shall be in accordapee with the attached NYSDEC approved plan, By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ~Ci., a}i applicable regulations, the t3eneral Conditfons specified (Sec Reverse Side) and any Special Conditions included as part of this permit. PERMII (\bMINISTRATl7ft p^:LSnFOP;>r :;:"t:~ Dayzd"'DeRidder Aboacss li~aton y.aa1C~. Go :.:;Er AUTHORlZED SIIiNATVKt !~M Iite4Y, lt.•Y, ilg9a •2ldAt /y~~GS,ct' .~~s,ed~~ OnrE 7/23/91 Page 1 af..4-- .rUL 26 '91 13:1~u PRGE,002 9 '91 13:54 FROG NEW YORK LIFE - PraGE.00., OyZOda fltYl7p}-SSe ADDITIONAL GENERAL CONDITIONS i6R ARTIGtES YS (Title 5), 24, 35, 3a, 76 and 6 NYCRR Part eA3 ( _ _ ) 9, Tha! if future opera@ons by !hv State of New York repairs an al- other environmentany deleterious mataNa4 associated with the teration in the peslllon of the structure or work herein authorized. ar Drojeet. {fr Ie the ,Yphtivn vl lbv pcpatOneul v( ainhunmm~mf ri,yll~ytyattpll 13, Any material dredged inlha prosecution of the wnt4 hernia permitted H shall puss unreasonable obstruction t0 the free navigation o/ said shall be removed evenly, without tearing large reface pile, Ndges atroes waten or flood flows or endanger the health, sa/sty or welfare of the teed of a waterway br floodplain or loop hales that meY have a the people of the Stara, or Cause lose or destrvetion of tM natural tendency to ease damage to nes4gabiv r.hannnts ur to the banks of resa,rces of the State. the pwAer may ba erdernd hY the Department to a waeerwey. t nmoVa Or altar rile structural work, obstructions, or hazards caused 14, Thaw Shat) be no unreasonable mtetferpnro wish navtgedon by the work thereby w{shout aapense to the State, and if, upon rtes ex9iration or herein authprlZCd. favexatlon Of (hit permll, the structure, fill, excavation, or other 15,, If upon tff0 expiraFron or revocation of this pprntit, the project hereby mtsdifiCatlon of the watercourse hereby authtadzed shall not be cam, autlrwized has net been cwnplettd, lhr, applicant shall, without expense pitted, the owners, Shall, without expense to the State, and !O such to the State, and to such extent and in such lima and manner as the extent dad in SUCK lime and manner as the l7rparkmant pf Environmental pppertment Of Environmental Consarvatinn mdY nKiuhv, ntmnve all pr Cg7xwatlon mayregUlrp, remove all nr any po+tionof the uncompleted any ponitan o4 the uncom !trod atructurn structure o+ fltl and reROra to itf former condition the naviaahle F nr f1H and resk>rt• the site and flood Capacity a! the wetertouna. Ne claim shall be msde against to its former condition. NO clAlm shat! br. made rtgNnst the Steep of the Stela of Naw York on aeaount of any such removal er akeration, York on account of any such mmnval a altrratinn. TQ, "Chat the State pf Naw York shall in no case be liable for any damage 16. If granted umJer Article 36, this permit dom nm signify In anY way that the poject will ba free from flooding, Oflnjul'ytothestruafwearworkharoinau;horizedwhlChmaybecaused 77. If grantedunder6NYCftflPart6gA.th@Ny$DrrS.trtrnCntofFnvlram by a res41t from 1ulura pparatlons undertaken by the State for the mental Conservation hereby certifies that ihu,uh't n ro eft will not COnfaNat(on or improvement of navigation, or for other purposes, and I • p I no claim or right to compensation shall accrue from any such damage. eontravme affluent (imitations or ether limi}atiuns er atdndards under 17. CraMing of this Dermit does nos relieve the applicant of rite responsl• Sections 301, 302, 303, 306 and 107 0/ the Clrnn Wntar Act of 1977 4PL 95•Z77) provided that all of tM aondldona Ihp•d herein are mal. blllty pf obtalnlnE any other parmnsmn, consent or approval from ia. A71 activitiaa authmt:ed by tbls permit must be in Ndrt conformance the U.S. Army Corps o! Engineers, U.S. Coast Guard, New York State with the approved plans submitted by the applicant or his agsnt as pare DHI[e Of CCneraf Servicef Or local government which may be required. of the permll applira3tipn, 72. All neeessaty precautions shalt be taken to preclude contamination Of any wetland or waterway by Suspended solids, sediments, facts, Surf! appfpved planf Wefa pr¢pared by solvents, lubricants, eppXY coatings, paints. concrete, Ieachata or any nn _ trnDLFLBD SPECIAL GONDiT10N5 r 1. Development of a single family dwelling on Lot no. 1, landward Cnortheasc) of the "Building Setback Line", wi21 not require a permit pursuant to bNYCRR part 661, provided that there is no grading, clearing, discharge of sediment, or other alteration to areas below the existing ten foot contour. 2. Ott I.ot No. 1, the strip o.f lan8 ten 'feet in widt lying landward of the area of steeper slope (designated on Che map accompanying Chia permit by a shaded or hatahcd area .noted as "Area of 30~ Slopes") shall be kept in law maintenance plantings or natural vegetation and shall not be mown or cut to a height less than eighteen inches CIS") in order to minimize the incidental tttovement of sediment and nutrients toward the bay. Vegetation may Consist of indigenous plants or nursery stock( aC the owner's opCionr but shall be planted in sttt:h a manner as to form a dense $rnund cover to a height of at least eighteen inches, 3. Any expansion of the existing one and ens-half slaty pause on Lat No. 2, artd any regStlated activity to be nonducted within the tidal wetlands and adjacent area on ••Lot Na, 2, shall be sub,ieet to NYSDEC review and permit requirements. 4. The pelvtittee is advised of thQ prest!nca of a nesting colony of Least Terns, a New 'lock State endangered species, it»ediately west of the pond on Lot No. 2. To avoid disturbing the S,east Tet•ns, there shall be no construction or other activity within 1Sp feet of any active nest between the dates of April 15th and August 3tst. 3upplctmentary Specisl Conditions CA) thrss(9) attached. 1-4738.:00203/00001-0 PROCaAMKACtLITV NVMBER Page 1 of a l i t 9 C rot t v. t o i 765-1802 BUILDING DEPT. INSPECTION FOUNDATfON i5T [ j ROUGH PLBG. [ ] FOUNDATIQN AND [ ] INSULATION [ ]FRAMING [ ]FINAL -REMARKS: ~2~ ~ - DATE l INSPECTOR k- _ h _ aoiq~ T65-1802 BUILDING DEPT. 1 NSPECTI4N [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION (]FRAMING FINAL REMARKS: ~ ~ C~,, O f C DATE ~.S 91- INSPECTOR Y. G.L . TGS-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST [ }ROUGH PLBG. [ J FOUNDATION 2ND [~j INSULATION [ }FRAMING [ ]FINAL REMARKS: d~ ~d._ i C1,,R.0.. w,-~~ C~~ t ~ DATE ~ ~ INSPECTOR ~©t~ 765-1802 BUILDING DEPT. INSPECTION ] 'FOUNDATION i5T [ ~ ,ROUGH PLBG. [ OUNDATION 2ND [ ]INSULATION [ J FRAMING [ ]FINAL ~ ` 'REMARKS: t DATE INSPECTOR ~ 4 1 3. Nature oCwork (check +vhich applicable): Ne+v building ~ Addition ~Utcration' Repair RFmoval , , Demolition ,Swi:nni,rtg 'D o0 Tennis Court alas. ~3 Iypgl~....... . Accessory Building..........Fcnce .......ocht~''ty~ork.. 4. Estimated Cost.....YP:.~~Ol ~Od,,,,,,,,,,,,,,, Fee 4tn be paid on Cling this applicatian~ 5. If dwelling, number oC d+vclling units O /V , , , , , Number of dtvclling units on each floor . , , , , , , , • • If gars^_e, number oC cars ........•J'?(~~: .Crc~ ttZ.~... f(I/, . 1~u~~' L;Lji~1(9. , P Y, P y NR, If business, commeraal or mixed occu anc s ecd nature and extent of each t pe of use 7. Dimensions of existing structures, tf any• Front . .Rear Depth , - Hcicttt ; Nuntbcr o(Storics • • - . Dimensions of same structure with alterations or additions: Front ~ ~ Rear . • • • • ~ ~ • • Depth .Height Number of Stories . . 8, Dimensions of entire new constnrction: Front ~ !d Rear , g'~;-!Q`~ Depth t~~i~ Hci;ht ~4, , 6 , , , , Number of Stories . ~!O 6UYt'<¢ ~t/2L .~las~`h2~A/ j; 9. Size of let: Front .....fda j'x; , , • , , , Rcar , j,~$,f'r,T. • ~ Depth ~/l5F,T., ~ ~ • ~ • ~ • 10. Date of Purchase , , , , , , , j,q9/ , • . , , , , , , , , ,Name of Former Owner NlCrt'R/(Co;Gfj. JtCOL~: 11. Zone or use district in which premises arc situated , . t`~:.~d dl'/N(¢ C, ~/'~L°1 ~E~iD~!GS 12. Does proposed construction violate any zoning law, ordinance or regulation: . ......./.V . 13. 1Vi11 lot be regradet} L1,~S,' , Nill excess fill be removed rom premises' Yr. 14. Name of Owner of prctxtises ~ ,y~,~-; //off-/~! Addresso°jQ~?~r~prq~?~'G!~.~j .Phone No. ,'j"':- • • • L Name of Architect+~jf(~7SS', ,~^~/10 , Address. c~.~ /.~1~yN~D;(~[jl,L';f~ phone No. ~~?.:~7~~1.~~. Name of Contractor . .Address ....Phone No. f.'i_Ls this property located within .300 feet of•a tidal wetland? *YES.X .NO.... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAA} Locate cleazly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dime^sior.- property lines. Give street and block number or description according to deed, and show street names and indtcatc interior or corner lot. j>R/a~tJG/~C~S STATL OF ~E1V YORK, S.S COUNTY OF . (~~'~~.`tr , • • • ~~lf • • • • • • being duly sworn, deposes and says that he is the applita: • • ~ • ~ • ~ ~ • .(I~`amc of individual signing contract) above named. ,c-/p ' fie is the p. w,NY.` . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file tl: application: that all statements contained in this application arc true to the best of his knowledge and belief; and that t1: +vork will be pcrfomtcd in the manner set forth in the application Glcd thcrc+vith. Stvom to bciorc me this .........dayar....G...... ,1~.9,/ 'r\'otar}•Public, ~~~~~~County ),,~o -opS~t~oo ~`.,~`~'"_'`?~.,'"s;3d, X99.2. (Si;nature of applican' yy~ BOARD OF HEALTH Q~~~""'~~i' ~ w 7 SETS OF PLAYS ,~l FORM MD.1 SURVEY I~IJG-8I99I I TOWN OFSOUTHOLD CHECK ` BUILDING DEPARTMENT SEPTIC .FORPI • • BLpG. DEPT. L~JJ ! TOWN HALL TOWN OF SOUTHOLD SOUTHQt.D,,1~1.Y_ 11471 tJpT I P\' ~ ~~77 . / ,,..~~~~yy..~n~~ CQ~ ' TEL.: 7G5.1B02 CALL .,C~~~ Examincd.~.~c'!.1•, f9`~1 MAIL T0: Approved Q°~~, ~ trait N • . . r~R ? . re a. ~ o 19 ~ . Disapproved a/c ' . ~ a.L. (But ding Inspector) ail APPLICATION FOR BUILDING PERMIT Date I5. j ~ INSTRUCTIONS a. This application must be completely filled in b ~ "sets of plans, accurate plot p{an to kale. Fee accordin Y typewriter or in ink and submitted to the Building Ins b. Plot plan showin^ location' ~ to schedule. Pectnr, will or areas and ~ of lot and of buildings on premises, relationship to adjoining premises or public sire; cation. , ,tvin, a detailed description of layout of property must be drawn on the diagram which is part of this apF c. The work covered by this application may not be commenced before issuance of Building Permit. -d. Upon approval of this application, the Building Inspector will issued a Building Permit to the a lie shall be kept on the premises availaf5le for inspection throughout the work. e. No building shall be occupied or used in whole or in part for an pP ant. Such perry shall have been granted by the Building Inspector. Y Purpose whatever until a Certificate of Occupant APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buildin Pe , Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances < Regulations, for the construction oaf buildings, additions or alterations, or for removal or demolition,rarrsttherein describe The applicant agrees to comply wi h all applicable laws, ordinances, building admit authorized inspectors on pre~ises and in building for necessary inap too + housi c e, d rem ,ulations, and t I ~ . • ure of i ~t, or name, if a corporation) ~ • . ~ ;~gp7'G/oYii.tP P7'C. /~03 NY~N.Y. /OOa/ (M . ing address of applicant) ~ • ~ • - State whether applicant is owner, lessee, agent, architect eng inter, general contractor, electrician, plumber or builder Name oC owner of premises J!~/,C;l? y t:9.. ~fp~c fN • • • . • • • . • . ,F,,tOi!.1 , ~~~/.j ..:M~r~/UG(yy~)`' KOGbC N~1.-~• ekinir-Q !C applicant is a corporation, signature of duly authorized officer, the tax roll or atest deed) ~j Le/~~~'• "~~1~ A • (A`ame and title of catpor~tc officer) ~ • • Builder's License No..., , , , , , Plurnbcr's Liccnsc No. . , !~D!?7'~i9' P>l%~JQ f ~/~-p6 ~Ya'~ ay Electrician's Licc ~ '~~~N ClfaJ'~"iY. nsc No. Ld'c%E/vJ'S Otltcr Trade's Liccnsc No. , ,I , , ~ ~ ~'Z` 1°/°LG .AS coNa'~/dC73' I • Location of lanryd on which proposu',d work will be dorc; ~ W SRO IlouseNumbcr ....Street. ,GUTGI•fe7~tlE • Hamlet County Tax i\tap No. 1000 $ectionl ,(F,~, • Subdivision N,4SS~9Gf POINT GLV,t~ Bloc.l, Lot'~:~ . • . F.ilcd flap No. State esistin^ use and occupancy o'flprcmiscs and intended use and occu • • • 7.~5, ~ • Lot . . 0 PancY of proposed construction: - A. Existing use and occup'iancy..... ...,,~~C!~N•r•• dC.U`j B. Intended use and occu ',ant L E ~/s M • a 1 i ~ ,.e. ~ I I~SUPP4EMEN~`ARX SPECIAL CONDI'PIUNS The following conditi',ons apply to all permits: A. IP any of khe per~;mit conditions are unclear,Che permittee shall con- tact the Diviaionl, of Regulatory Affairs at the address and telephone poked below., B. A copy of this permit wikh supplementary conditions and approved plans shall be available at the project site whenever authorized work is in progre'ns. C. The permit sign a closed with the permit or a copy of letter of approval shall berprotected from khe, weather and posted in a con- spicuous location at the work site uirkil completion of authorized work. D. At least 48 hours,prior to commencement of the project, the permittee shall complete an return the top portion of the enclgsed receipt form ~I certifying that h~ is fully aware of and understands all provisions and J conditions of thin permit. Within one week of completion of the permitted work, type bottom portion of that form shall also be com- pleted and returned. E. Far projects invol,Ving activities to be accomplished over a period of more than one year, the permittee shall notify the Regional Permit lidministrator in Writing at least 48 hours prior to, the commencement of resumption of work each year. F. iE project design ',modifications take place.after permit issuance, the permittee shall sUibmit the appropriate plan changes for approval by the Regional Permit Adminisl-rator prior tc undertaking any such.modi- i ficat-ions. The pe;rmi,ttee is advised that substantial modificaticn may require submislsion of a new application For permit. G. All necessary precautions shall be taken to preclude contamination of any wetlands or wajterway by suspended solids, sediment, fuels, solvents, lubrican'~ts, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated 'with the project work. I~ ti. Any failure to comply precise]y with all of the terms and conditions of khis permit, unless authorized i,n writing', shall be treated as a violation of the E~tvironmentai. Conservation haw. • I. The ~ i permittee is advised to obtain any permits or approvals that may be required From khe U.3. uepartment of Army Corps of Engineers, NY District,.26 Feder~l 1?laza, New York, NY 1027A, (Attention: Regulatory Functions Branch),!, prior to commencement of work authorized herein. J. The ,g ranting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, `Power Building, Empire Skake Plaza, Albany, NY 12292, which may be required fox any encroachment upon State-owned lands underwater. II', Regional Permit ndmi.nistr. ator NYS Dept. of Environmental Conservation I Bldg. 40, SUNY-Room 219 I Skgny Brook, NY ].1799-2356 (51:6) 751-7900 DEC It ~ • 4~i 3 ~ Uy~,~c~3/~~ -U Page c p ~ II T-------- I ? ~ ~ Z V~ _ a ~s v Z M 9g eS~ ffo2 ~ ~ po rn . Q O ~ ~ h {moo ~ o z:~,,,~. r 9S r> ~ o p w~ ZIP\UN ~ UN ~ O O ~ O Q Z r^ O W : V! 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